Clinical Research Papers:
Comparison on efficacy of radical prostatectomy versus external beam radiotherapy for the treatment of localized prostate cancer
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Linyan Chen1,*, Qingfang Li1, Yexiao Wang1, Yiwen Zhang1,* and Xuelei Ma1
1State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University and Collaborative Innovation Center, Chengdu, PR China
*Authors contributed equally to this work
Xuelei Ma, email: [email protected]
Yiwen Zhang, email: [email protected]
Keywords: prostate cancer, external beam radiotherapy, surgery, meta-analysis
Received: May 05, 2017 Accepted: July 26, 2017 Published: August 09, 2017
Since there was no consensus on treatment options of localized prostate cancer, a meta-analysis was performed to compare the efficacy of radical prostatectomy (RP) versus external beam radiotherapy (EBRT) concluding three-dimensional conformal radiotherapy (3DCRT) and intensity-modulated radiation therapy (IMRT). The search of eligible studies was performed on PubMed and Embase databases. The overall survival (OS), cancer-specific survival (CSS) and biochemical disease-free survival (BDFS) were compared by hazard ratio (HR) and odd ratios (OR). Twelve studies with 17137 patients were included. The pooled HR and 95% CI for OS, CSS and BDFS were 1.60 (1.44–1.79), 1.73 (1.34–2.24) and 0.65 (0.51–0.82), respectively. However, according to risk stratification, the HRs of CSS for low- to intermediate-risk patients were not significant. The 5-year and 10-year CSS reported significant OR and 95% CI of 1.96 (1.42–2.72) and 2.44 (1.33–4.48), except for 2-year CSS (P = 0.42). In conclusion, RP was generally associated with decreased risk of overall and cancer-specific mortality as well as better 5-year and 10-year OS and CSS. The EBRT was suggested to be a promising alternative option for low- to intermediate-risk patients. Large-scale prospective studies with risk stratification and adequate follow-up length were needed for further comprehensive comparison.
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